Case Studies

Representative outcomes from healthcare transformation work

Examples below are anonymized and highlight common challenges I solve for payer and provider leadership teams.

Transformation May 27, 2026

Reviving an abandoned D-SNP risk adjustment program — and lifting RAF ~30% without adding audit risk

How a dual-eligible plan went from flying blind to documenting a population it could finally see — RAF 1.07 → 1.39 over two years, every condition coder-reviewed and built to withstand RADV.

Transformation May 27, 2026

Reversing a five-year risk-score slide — and beating the recovery target the defensible way

A regional Medicare Advantage plan had watched its risk scores fall for five years. RAF recovered 0.85 → 0.95 in 18 months — 160% of the recovery goal — with every delete auditor-reviewed.

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